Active NPI
Sungeun Julia Park, PHARM D
- Pharmacist
- Waldwick, NJ
National Provider Identifier
1609158518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03338600
- Practice address
- 72 Crescent Ave
Waldwick, NJ 07463-1345 - Phone
- (201) 444-2754
- NPI assigned
- Sep 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03338600 | NJ | Primary |
Addresses
Primary practice location
72 Crescent Ave
Waldwick, NJ 07463-1345
Mailing address
65 Fairview St Apt 2I
Palisades Park, NJ 07650-1073
Phone (347) 554-0324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03338600 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1609158518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 FAIRVIEW ST APT 2I",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501073",
"telephone_number": "347-554-0324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 CRESCENT AVE",
"city": "WALDWICK",
"state": "NJ",
"postal_code": "074631345",
"telephone_number": "201-444-2754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SUNGEUN",
"middle_name": "JULIA",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-16",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03338600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldwick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.